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ELEC��tICAL PERMIT APPLIGA,TIOIV <br /> CITY OF EVERETT PERIVIIT SER�'ICES <br /> 3200 CEDAR STREET, EVERETT, WA �8201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.or� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM � _ �'j /D <br /> �s i s� c'<�, /2�� .��%=, /�ri��� ���G�i� 9��� <br /> PROJECT ADDRESS <br /> Owner Mail Address Cily State2ip Phone <br /> Tenant Mail Addross City � Slale/Zip Phono <br /> i <br /> �� �j C /y �/',p/ <br /> '�/�-���/�� IG��(.T�iG C'XJ,:r /✓• /3 �f `f` /.'fl•��G� G�✓// �('f' �3 <br /> Electrical Contreclor Mail Address City Stale/Zip Phone <br /> �i+�3l 77�:a� <br /> �c, S/�=f' ,EciG/ ��= -� J�'c:' G <br /> Slate Lice'nse Number Contract Price of Work <br /> �- � � <br /> ��fjCOr'� .�["arr/- /J�"�i�L-/f <br /> r � <br /> Proposed Use oi Buildiny Contact Person (Plan Review) <br /> Description of Work lo Be Done: /���"/� / �'`'�c�� _ <br /> T—' <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> , CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> � /hereby certi(y that 1 have mad and examined this application and know the same to be Irue and <br /> correct. A/l provisfons olla�vs and ordinances governing this type of�rork will bc complefed � �,(J O "rl —C C�' <br /> uhdfher specilied heiein or noL The gr�antinc�o/a pernu!doas not presume to�ive authonty to <br /> violafe or cancel tho�rovisions ol eny other state or local law regulating construcfion or the <br /> perfomit�nce o(construction. That I am authorized by the owner ol this property to perform the <br /> work/orYhich application is mado and 1 compty�vifh fhe Sfate Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> �%� ,S/S /L' <br /> Sig aWre�� Date <br /> v '� <br />